Wednesday, September 22, 2021

Axios Vitals: Delayed care might not have been all bad

Plus, Walgreens' latest $940M splurge | Wednesday, September 22, 2021
 
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Axios Vitals
By Tina Reed ·Sep 22, 2021

Good morning, Vitals readers. Today's newsletter is 736 words, or a 3-minute read.

Situational awareness: The U.S. is set to let fully vaccinated travelers from 33 countries into the country who have received shots that aren't yet authorized here in the U.S. by the FDA, like the AstraZeneca vaccine. But for international students who are coming here to study, that may not be the case, the Axios Today podcast team reports.

 
 
1 big thing: Kidney care dropped during the pandemic
Animated illustration of a loading icon over a medical cross.

Illustration: Megan Robinson/Axios

 

The number of patient visits for chronic kidney care plummeted by more than 26% in the early months of the pandemic, according to new data from the nation's largest insurer, UnitedHealth Group.

Why it matters: Researchers are racing to understand just how much care people skipped — and whether it actually affected their health.

What they're saying: "The key number to keep in mind here is that roughly 30% of the care that patients receive across the health care system doesn't help them and may even put them at risk. That's likely true with kidney disease care, too," said David Cook, vice president of research at UHG Research and Development.

By the numbers: UnitedHealth's study looked at changes in in-person visits, as well as lab work and medication utilization, between March 1 and June 30, 2020.

  • Researchers said they would have expected to see 2.74 million in-person visits in the study period. Instead, they saw a total of only about 1.56 million in-person visits, representing a 40% drop.

What we're watching: Anecdotally, doctors have said they're starting to see negative effects of delayed care across the spectrum of health care.

  • "That wave is now crashing," said Gregg Miller, the chief medical officer of Vituity, a firm that staffs hospital emergency departments.

What's next: As patients head back to the doctor, United is waiting to see whether they've gotten sicker, or whether the pandemic ultimately helped identify care they didn't really need.

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2. Walgreens' specialty pharmacy deal

More hospitals are opening their own specialty pharmacies. Photo: Daniel Acker/Bloomberg via Getty Images

 

Walgreens paid $970 million to increase its ownership of Shields Health Solutions — a company that helps hospitals run their own specialty pharmacies — from 23% to 71%, Axios' Bob Herman writes.

  • Standard Walgreens pharmacies are ubiquitous throughout the country, but this deal will give Walgreens a bigger position in specialty pharmacies, which handle pricey medications for complex conditions and have become very lucrative.

The big picture: Many drugs are now classified as "specialty" medications — everything from drugs that need to be administered with a needle to pills that treat cancer and HIV.

  • Pharmacy benefit managers own a majority of the specialty pharmacy market, but hospitals have increasingly started in-house specialty pharmacies to get a piece of the pie, according to the Drug Channels Institute.

How it works for Walgreens and Shields: Hospitals hire Shields to set up the pharmacies, and Shields takes up to 30% of the revenue as its fee, according to the Boston Globe.

What to watch: Walgreens could acquire the remainder of Shields for an estimated $1.25 billion, according to a financial filing.

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3. Seniors' out-of-pocket spending on dental
Data: Kaiser Family Foundation; Chart: Will Chase/Axios

About 31.3 million Medicare beneficiaries (53%) paid an average of $874 out-of-pocket for dental services in 2018, a new analysis from KFF shows.

  • About 4.6 million beneficiaries (8%) had average out-of-pocket spending on hearing care of about $914, while 30.2 million Medicare beneficiaries utilized vision services and had an average out-of-pocket expense of $230.

Why it matters: Democrats' reconciliation bill would expand Medicare to cover dental, vision and hearing benefits.

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A message from PhRMA

Myth vs. fact: Americans and Medicare negotiation
 
 

Key numbers:

  • 65% of Americans (KFF) oppose negotiation if it leads to less research and development of new treatments or if it limits people's access to medicines once they come to market.
  • 76% oppose H.R. 3-type "negotiation" if it causes delays in access to new medicines.

Get the facts.

 
 
4. CMS launches nursing home vaccine tracking
Data: U.S. Centers for Medicare & Medicaid Services; Map: Thomas Oide/Axios

CMS added nursing home vaccination rates, including staff and residents, to its online comparison tool at Medicare.gov.

Why it matters: Nursing homes proved to be a major vulnerability in the U.S., incubating some of the earliest and deadliest outbreaks of the novel coronavirus among elderly residents.

Between the lines: Last month, President Biden announced nursing home and long-term care facilities must vaccinate their staff against COVID-19 to continue to receive federal Medicare and Medicaid funding in response to lagging vaccination rates and a surge of new cases from the Delta variant.

By the numbers: 84.1% of nursing home and long-term care residents are vaccinated against COVID-19 and 63.7% of staff are vaccinated, according to CMS data.

  • In total, 686,104 nursing home and long-term care residents have contracted the virus as of Sept. 16, up 3% from last month, when there were 664,815 cases reported.
  • And 135,427 have died from COVID-19, up about 1% from 133,631 last month, the data shows.
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5. Catch up quick
  • Manufacturers are warning that the U.S. is, at best, weeks away from the production levels needed for President Biden's plan of mass-scale rapid COVID-19 testing. (Axios)
  • An ex-Theranos employee testifies that guilt was a "common theme." (Wall Street Journal)
  • An insider from the Purdue Pharma Bankruptcy speaks out. (New Yorker)
  • Their baby died in the hospital. Then came the $257,000 bill. (New York Times)
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6. 1 fun thing

Illustration: Aïda Amer/Axios

 

If you're looking for a not so politically-correct explainer on COVID-19 shots, the TV show Family Guy has you covered.

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A message from PhRMA

New CBO Report: HR3 would result in at least 60 fewer new medicines
 
 

New CBO report finds that even under its conservative assumptions at least 60 new treatments and cures will be sacrificed if H.R. 3 becomes reality.

Instead, Congress should focus on commonsense, patient-centered solutions to address voters' true concerns, like lowering OOP costs.

 
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